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August 27, 1999     Cape Gazette
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August 27, 1999
 

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CAPE GAZETTE, Friday, August 27 - September 2, 1999 -43 HI00. 00LTH & FITNESS Deceiving symptoms often mask reflux disease By Kerry Kester More than 20 million people in the United States are estimated to have reflux disease in some form. Often, the disease goes undetect- ed until a patient begins to suffer from some of its more trouble- some symptoms. Other times, it is mistakenly diagnosed as asth- ma. The disease often presents as heartburn or as respiratory disor- ders. For example, patients may have hoarseness, a sore throat or bitter taste in the mouth; they may have choking episodes in the mid- Reflux Disease Symptoms die of the night or they may expe- rience wheezing attacks. Any of those symptoms could be attrib- uted to other conditions, so it isn't unusual for reflux disease to be missed. "It's not necessarily associated with one disease pattern," said Dr. Paul Taiganides of Delaware Bay Surgical Service. The condition develops, he explained, when the band of muscle fibers around the stomach don't function properly and pinch the esophagus - the canal that runs from the tongue to the stomach. When that occurs, stomach acids, bile, or both creep upward through the esophagus. Taiganides said sometimes peo- ple breathe in the acid, which then circulates through the lungs to cause respiratory problems. Other times, people may not be aware the fluids have come up and may find themselves waking in the night with the sensation they are choking. Yet others may disregard some symptoms but find themselves sleeping on sev- eral pillows to keep propped up at night -not realizing there is a cause for their nighttime discom- forts. "Many people have lung prob- lems from it and don't realize it's actually reflux," said Taiganides. If left untreated for a long time, the danage to the lungs can be permanent. Additionally, reflux disease can cause life-threatening damage from the acids or bile flowing in the esophagus over a long period of time. Severe cases of reflux disease can result in ulcerated, bleeding or perforated esophaguses. The combi- nation of bile and stomach acid can also cause Barrett's disease. "Barrett's is a known pre- TAIGANIDES cancer state," said Taiganides. Although not everyone who has Barrett's dis- ease develops esophageal cancer, he said, most patients with esophageal cancer have Barrett's disease. Hernias reflux ally Hiatal hernias are closely asso- ciated with reflux disease, said Taiganides. The hernia develops when the junction of the esopha- gus and stomach pushes up above the diaphragm. The stomach becomes pinched where it has pushed above the diaphragm, causing a weakness that allows stomach fluids to move upward in the same manner as withreflux disease. , Symptoms usually include heartburn after meals or when lying down. The heartburn may also occur during exertion, partic- ularly if the person is bending for- ward. Other symptoms include vomiting, belching, intestinal rumbling, rapid breathing, diffi- culty swallowing or a dull pain To diagnose either reflux dis- ease or hiatal hernias, physicians may suggest patients change their diets and lifestyles, or they may prescribe medications. Some of the diet changes include avoiding caffeine, chocolate, fatty foods and alcohol. Lifestyle changes may involve losing Weight for those who are overweight and smoking cessation for those who smoke. Exercise programs may also be recommended. If symptoms persist, said Taiganides, then physicians may recommend a gastroenterological evaluation. Gastroenterologists conduct endoscopic tests that will reveal precisely what the prob- lems are and the best courses of treatment. In some cases, the rec- ommendations will be for surgery. Taiganides said the most com- mon surgical remedy is to free the natural attachments at the upper portion of the stomach, then wrap the stomach around the junction where the esophagus meets it. In so doing, the pressure is restored, so the valve is mechanically stronger and able to do its job bet- ter. 'q'he success rate is more A hernia develops when the junction of the esophagus and stomach pushes up above the diaphragm. The top of the stomach becomes pinched, causing a weakness that allows stom- ach fluids to move upward in the same manner as with reflux disease. than 90 percent, but for people to have the surgery, they must meet certain criteria," said Taiganides. What is particularly nice for patients, he said, is the procedure may now be done laparoscopical- ly. From what once was a six- to seven-day stay in the hospital, the procedure now usually-involves only one or two days of hospital- Continued on page 45 Good nutrition e,,000000t.00ntial for athletic performance What is good sports nutrition? Many people's beliefs and prej- udices regarding nutritional prac- tices are very conservative. Athletes are continually looking for special foods and diets that will help to improve their per- formance. Unfortunately, many athletes are not knowledgeable in regard to nutrition, and therefore fall vic- tim to those who market under false pretenses. Proper supplementation is often necessary for full replenishment of vitamins, minerals and food- stuffs used by athletes. The old shotgun approach has been disclaimed as bad practice in order to receivebenefits of nutri- tional supplementation. Because your body goes through various phases of breakdown and rebuild- ing, supplements that are used for rebuilding are best taken when your body is capable of using them. Your nutrition and nutritional supplements should he taken for increased work capacity and a speedier recovery, not solely to compensate for used energy. A proper combination of food types HEALTH TOPICS Dave Kergaard Dave Kergaard, certified by the International Sports Science Association, is a per- sonal fitness trainer. For information, call 227-8095. I can be crucial to supplying ample energy for your particular physi- cal demands. Not all athletes require the same nutrition, but without good nutri- tion and proper supplementation, you will find it difficult to improve physical performance as well as physical appearance. It's a fact of life; we need to eat to live, but to an athlete or serious fitness enthusiast, it is just not that simple. The proper quantity and quality of nutrition becomes increasingly crucial to the various demands we face in rigorous sports and fitness training. There are six major nutrient essentials to healthy living and prosperous athletic endeavors. These are water, vitamins, miner- als, proteins, fats and carbohy- drates. Although conservative nutri- tionists preach balanced meals consisting of foods from each of the four food groups for peak per- formance, sports nutritionists are now finding that this is just not adequate. As an athlete expends calories and utilizes various substances through intense physical training, full replenishment of used up sub- stances is difficult through a well balanced diet alone. Besides, how many people do you know who eat a well balanced diet all the time? This is why nutritional supplements are neces- sary for aspiring athletes as well as experienced trainees: By not consuming all the need- ed nutrients mentioned above each day, your workouts may be less than maximal. Even if you are deficient in only a few of the major nutrients, this can diminish potential. It is equally important for you to know how, what and when to eat. Much of the scheduling and selection of meals is determined by your physical demands in training and competition. The chief reasons that you can- not eat randomly is that you need sufficien t energy for the work you are performing for training recu- peration. Remember, your needs are quite different from the average (inac- tive) individual. To substantiate these claims, research provides us with infor- mation that shows that athletes can burn nearly one-third more calories from nervousness alone. Even the calorie expenditure dur- ing competition can be more than one-fourth more than utilized dur- ing training sessions. It is well established that your diet allows you to do more and be a beu.er competitor. Your diet needs to meet both your energy demands and nutri- tional substance requirements, and your diet will be effective only when it meets all of these various demands placed on it through physical activity. If you do not meet these demands through your diet, you can easily overtrain and become extremely fatigued. You must organize your nutri- tion according to the phase of training you are in at the time. Regardless of the current training phase, it is necessary to replenish all energy stores, and consume vitamins and minerals essential to proper body functioning, and your requirements during each phase can vary considerably. The same is true of general fit- ness training. Much depends on physical size, metabolism and past eating habits combined with training volume, duration and intensity. Remember, training is only part of the formula for fitness success. Proper nutrition is equally impor- tant in your quest to become phys- ically fit.